Epilepsy

What is Epilepsy?

Epilepsy is a common neurological condition which affects the nervous system. Epilepsy is also known as a seizure disorder. It is usually diagnosed after a person has had at least two seizures. The seizures in epilepsy may be caused by a brain injury or a genetic disorder, or the cause may be unknown.

What is a seizure?

A seizure is an electrical abnormality in the brain that can temporarily affect a person’s movements, sensations, thoughts and actions. Seizures may result from many different disorders that affect the brain. They can range in severity from unnoticeable to life-threatening. They can be partial (occurring in part of the brain) or generalized (occurring throughout the brain). They are also classified as simple (patient is wide awake) or complex (affecting level of alertness), ranging from mild confusion to complete loss of consciousness. The classic “grand mal” (or what is now termed “generalized tonic clonic”) seizure involves stiffening of the muscles, shaking, loss of consciousness and brief disruption of breathing. Other types of seizures include absence (typically in children causing disruption of awareness and staring) and myoclonic seizures (causing muscle jerking). Most seizures are brief, lasting from a few seconds to a few minutes, but a seizure can be sustained, quickly becoming a medical emergency.

Diagnosis

Diagnosing a seizure disorder may be challenging. Many other neurological abnormalities can be confused with epilepsy, so it is critical to make an accurate diagnosis to provide the appropriate treatment.

A critical piece of information in determining the type of seizure disorder is the description of the event by those who witnessed it. However, other information is often needed to make the proper diagnosis, including a review of the medical history, blood tests, brain imaging tests such as CT and MRI and sometimes a lumbar puncture. These tests provide information regarding the structure of the brain (what it looks like), the environment the brain is in (through blood and spinal fluid tests) and the electrical activity of the brain (how it functions). An important tool in the diagnosis of epilepsy is the electroencephalogram (EEG). The EEG measures the electrical activity of the brain from less than an hour (routine) to sometimes several days (the latter often combined with video monitoring as a video EEG), and can provide critical information in diagnosing and treating the seizure disorder. More complicated cases may require even further testing.

At Orange Regional, we offer patients access to expert epilepsy care. Often neurologists will treat the seizure disorder with medication. For many patients, medication alone is sufficient to control the seizures. If medications are insufficient, additional diagnostic and treatment options may be indicated, such as advanced brain monitoring, more detailed imaging, implantation of neurostimulators, or surgery. Epilepsy specialists at Orange Regional can review all your options with you so that you can make the best, informed decision regarding your care.

What to Do During a Seizure

If you or a loved one is experiencing a seizure, seek medical attention immediately. The underlying cause may be life threatening.

Report your experience to your Primary Care Provider.

Inquire about a neurologist referral.

If you are a witness to a seizure, there are things you can do to help:

Keep them safe from harming themselves. Clear away objects that could pose a hazard.

Do not restrain them.

Do not place anything inside the person's mouth.

Do not restrain the person's movements, unless they place him or her in danger.

Turn the person on his or her side to open the airway and allow secretions to drain out of their mouth.

Stay with the person until the seizure ends.

Do not pour any liquids into the person's mouth or offer any food, drink or medication until he or she is fully awake.

If the person appears to be having difficulty breathing, call 911. If the patient does not resume breathing after the seizure, start cardiopulmonary resuscitation (CPR).